. Factors associated with Covid-19 social distancing ? such as isolation from family, restricted movement, insufficient sunlight and social and physical activity, lack of caregiver support services, and caregiver exhaustion - may adversely impact the well-being of older adults with Alzheimer?s disease related dementia. Because older adults with dementia are cognitively and verbally unable to express their distress, and both sunlight and activity are necessary for healthy sleep patterns, social distancing may increase agitation behaviors, worsen sleep patterns, and increase prescriptions for antipsychotics and sedating medications to manage these problems. We propose an Administrative Supplement to the NightRest study, R01AG051588, to determine the impact of social distancing on the well-being of older adults with Alzheimer?s disease related dementia. The primary specific aim is to determine the impact of social distancing on nighttime agitation and sleep. The hypothesis is: social distancing will result in more nighttime agitation and less sleep.
Aim 2 will explore the impact of social distancing on physical function and use of antipsychotics and other sedating medications.
Aim 3 will explore the impact of social distancing from the perspectives of family caregivers using qualitative interviews and a Facebook survey. The research will employ an observational study design. Participants from the NightRest trial, 50 pre- and 50 post-Covid-19, living independently or in nursing homes, matched on relevant variables, will be used for Aims 1 and 2. Content analysis of 30 family caregiver qualitative interviews (Aim 3) will result in a list of priorities to minimize the impact of social distancing. Family caregivers accessed via a Facebook survey will rank and add to the priorities. Because the NightRest study team possesses pre-Covid-19 data, has access to family caregivers who have expressed interest in future studies, and has developed and piloted virtual data collection methods, we are uniquely positioned to determine the impact of Covid-19 social distancing policies on well-being. We also have the ability and the networks to translate the findings. The results will be widely disseminated in November/December, 2020 to stakeholders and other policy influencers through social media, press releases, and presentations. The proposed project may result in more tailored social distancing policies in the future. Further, dissemination of nursing home realities to a world closely following Covid-19 developments may ultimately result in better nursing home care, not just for now, but also in the future.

Public Health Relevance

This study will determine the impact of Covid-19 social distancing on nighttime agitation behaviors, sleep patterns, dosages of antipsychotics and other sedating medications, and well- being of older adults with Alzheimer?s disease related dementia living in nursing homes and community settings. Findings will be widely disseminated in Fall, 2020 to stakeholders and other policy influencers through social media, press releases, and presentations. The proposed project may result in more tailored social distancing policies for older adults with Alzheimer?s disease related dementia.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
3R01AG051588-06S1
Application #
10167515
Study Section
Program Officer
Mackiewicz, Miroslaw
Project Start
2018-05-01
Project End
2021-03-31
Budget Start
2020-09-08
Budget End
2021-03-31
Support Year
6
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of Texas Austin
Department
Type
Schools of Nursing
DUNS #
170230239
City
Austin
State
TX
Country
United States
Zip Code
78759
Ye, Lichuan; Richards, Kathy C (2018) Sleep and Long-Term Care. Sleep Med Clin 13:117-125
Richards, Kathy C; Kovach, Christine R (2017) Comorbid Nighttime Agitation, Sleep Disturbance, and Restless Legs Syndrome: What Next? Res Gerontol Nurs 10:151-153